| Sunshine Care Partners Inc. | |
|
12162 S Waco Ave Glenpool OK 74033 | |
| (918) 304-8119 | |
| Not Available |
| Full Name | Sunshine Care Partners Inc. |
|---|---|
| Speciality | General Practice |
| Location | 12162 S Waco Ave, Glenpool, Oklahoma |
| Authorized Official Name and Position | Rusty Mcmurray (OWNER) |
| Authorized Official Contact | 9183048119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunshine Care Partners Inc. 9721 E 79th St Tulsa OK 74133-4572 Ph: (918) 304-8119 | Sunshine Care Partners Inc. 12162 S Waco Ave Glenpool OK 74033 Ph: (918) 304-8119 |
| NPI Number | 1285138438 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 08/22/2022 |
| Medicare PECOS PAC ID | 2163785122 |
|---|---|
| Medicare Enrollment ID | O20230405002653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285138438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Mark D Erhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770546640 PECOS PAC ID: 0648283937 Enrollment ID: I20230508000503 |
| Provider Name | Raissa Prisca Mabaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619541398 PECOS PAC ID: 1759775463 Enrollment ID: I20230508001300 |
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